Doctoring & Healthcare

All Articles in the Category ‘Doctoring & Healthcare’

This Makes It Tougher: LuluLemon’s False Claim

lulu lunch bagSometimes it can feel that a career of crafting prevention messages can be snuffed out in a moment. Every once and a while this work in media/messaging can take my breath away, for all the wrong reasons. Today, I realize my work educating parents and children about sunscreen use, UV radiation, aging, and skin cancer risks may pale in comparison to the potential power of a single quote on the side of a shopping bag. I mean, how can I compete with a company that sold $1.6B of merchandise last year and likely distributes tens to hundreds of thousands of reusable bags around North America everyday? Shopping bags have the luxury to walk around for years and tuck into peoples lives in remarkably intimate ways. Even I use these bags (or used to) to carry my lunch on a daily basis. It wasn’t until yesterday that I realized I’d been carrying my lunch around in a bag that goes, in part, against my entire mission. When I read about recent dermatologist outrage for Lululemon bag quotes I literally turned my head to my kitchen counter (see photo) and there sat my lunch bag on my counter just staring at me. Under the tote’s handle was the devious myth, “Sunscreen absorbed into the skin might be worse for you than sunshine. Get the right amount of sunshine.”

Now, that’s not true. In fact there is no “right” amount of sunshine and absorption concerns for sunscreen haven’t proved more dangerous than sunshine. Also, absorption varies with age and body site, here I review information about why to use physical sunscreens (and sun protective clothing) in infants when possible to reduce any risk from ingredient absorption because of their more immature barrier. That being said, I’d always recommend sunscreen over sun exposure for infants and children. The conversation about getting sunshine is centered around getting enough vitamin D. Although minutes (not hours!) in the sun provides vitamin D, we can safely get vitamin D entirely from the food we eat or a daily supplement (all children are recommended to have at least 400 IU Vita D daily). We don’t need to consume sun. In fact all sun exposure comes with UV radiation that contributes to mole production, aging, and skin cancers– even the most deadly kind, malignant melanoma. Sun protection keeps skin looking beautiful (prevents aging) and prevents skin from discoloration and cellular/immune changes that can lead to cancer.  Sun-protective clothing, seeking shade, and sunscreen are our best bets for beautiful, healthy skin. Read full post »

The Power Of A Sugar Cube


There’s no question the challenge of unhealthy weight and rising obesity rates in America present a complex problem for children, their parents, and their doctors. No wonder I cycled through so many emotions while watching the new movie Fed Up. As Fed Up premiers all over the United States today it’s provoking a fiery, national conversation about the threats of obesity on our nation’s children. I loved the power behind the film.

Instead of pointing the finger at children for poor choices or limited activity, filmmakers Katie Couric and Laurie David take a deep dive into the mechanics of how food is being made in America, how food companies have contaminated our culture, and how with a changing food source we’re obligated to return to a menu of primarily fresh foods to heal our children.

This movie is guaranteed to cause you to re-evaluate the number of processed foods you bring into your home.

Fed Up is constructed out of powerful interviews and activist-like thinking as national experts illuminate the fallacy that eating less and exercising more will singularly improve the health of our nation and curb the obesity epidemic. It feels a little like a get-out-the-vote campaign blended with a whole new kind of math. In fact there’s lots of new thinking challenging the simplicity of previously held beliefs about energy gap. With overweight and obesity threatening our longevity and our national bank account, Fed Up assures us that we’ll have to take on one big sugar cube, the food industry, to lean-up our nation. Read full post »

New Autism Numbers, Ways To Advocate

1 in 68 from CDCHeadlines soared yesterday with the CDC report that the number of children with autism diagnoses had increased by 30% in the past 2 years. “Reality is there are many children who are having serious struggles because they can’t communicate well and have a hard time being with people,” Dr Chuck Cowan clearly stated to me this morning. Like a bell on a quiet night, I feel parents need to hear this most: we just want to connect children with the resources they need to thrive at home and at school and throughout their lives. Doesn’t matter what we call it, we want children of all backgrounds, of all resources, and all opportunity to be afforded the chance for a connected, lovely life. As a realist of course, I do know that numbers matter because it changes how we screen, how we advocate for children, how we move funds and resources, and how we ensure children get what we need. Numbers help activate.

The new numbers don’t mean anything is different today than it was 2 years ago really. Instead:

The “new” number published this week finds an estimated 1 out of every 68 children here in the US has an autism diagnosis at age 8. Like before, likelihood for autism is more common if you have a family history of autism and 5 times more common for boys compared to girls. Children who aren’t white don’t get identified as having autism as often and we know from numerous studies non-white children don’t get the resources they need like their caucasian counterparts. That’s not new, either. Also, there may be environmental factors at play although data on determining true environmental causes of autism, versus associations, is still unfolding. Researchers are trying to sort out the role for chemical exposures, e.g. how close you live to highways, and what your children eats in predisposing a child to challenges with communication.

Over the past few months I’d say we’ve been bombarded with unsettling news; we’ve heard that autism likely starts before birth, that children born to older fathers are more likely to get the diagnosis and we’ve even heard that taking Tylenol during pregnancy may increase the odds that our children can’t pay attention. I mean, YIPES! Before you entirely freak out, listen to this: Read full post »

Digitally Savvy Parenthood

As a pediatrician, I encourage families to search online for health advice. Yet how you search and where you click matters. Tips for you and your time with “Dr Google” or “Surgeon Bing.”

The Pew Internet Project’s research finds that over 70% of Internet users in the United States say they have looked online for health information in the last year. Furthermore, most health information seekers (ie freaked out parents searching in the middle of the night) don’t start their health search on their pediatrician’s website. More than ¾ of people in the United States start their health search by typing something into a search engine like Google or Bing. Where you click and what you do next is key.

As a mom, pediatrician, blogger and general online enthusiast, here are a few insights to assist you when looking online for health information for your child or family. We parents are active information seekers on our phones and computer ~ I maintain that this is a GREAT thing! For practicing physicians, there is a tricky balance in believing that the Internet can help save lives. Have You Been In To See Doctor Google? A few ideas to improve trust for us all.

7 Tips For Becoming A Savvy Digital Parent:

Read full post »

We Want Your BPOD

And now for something a little different….We want to animate your child’s BPOD (Best Part of Day). Send us a short recording of your child talking about their BPOD and we’ll bring their experience to life in an animated video (see video above)! We’ll never disclose their name or age, just share their journey and insight through their words.

Email your recording to my Seattle Mama Doc email (seattlemamadoc@seattlechildrens.org) by Feb 26, and we’ll select 5-10 recordings to animate and share the first week of March. As a note, I typically record these audio recordings on my iPhone (in “voice memos”) and it allows me to email or share them easily. See below for more details & the text you’ll need to include when you send your audio files! Read full post »

CVS Stops Selling Tobacco

Doctors are tough critics — as well they should be. Today the news that CVS Caremark pharmacies will no longer sell tobacco brought about quite a bit of rapid online dialogue. Even President Obama chimed-in with praise, a response that some in the business world say is worth billions for CVS. Having a good reputation, particularly when you’re in the business of delivering health care and lending health advice, seems essential. In my mind we should praise and celebrate what today brings – leadership for making it harder to get addicted to tobacco products we know seriously harm health.

But not all doctors may think a move to ban the sale of tobacco in a health care environment is enough. Dr Sunny Chan, a family doctor in Canada, asked the tough question about our health care providers (HCP) working environment:

Meanwhile, Texas pediatrician Dr Bryan Vartabedian wrote a blog post this morning asking CVS to take a bigger step  by banning sales of unhealthy sugar-sweetened beverages (that we know are associated with obesity) and junk food. He wrote,

You can’t make money peddling savory snacks while at once setting the pace for a healthy lifestyle.  And condemning one vice works for the press release, but not as a brand offering health solutions.

When focusing singularly on CVS’ decision to stop selling tobacco products, it’s easy to say the choice is a phenomenal one. Not promoting (or profiting) from the sale of carcinogens is always in the best interest of our communities and our long-term health. I return to what Centers For Disease Control’s Director, Dr Thomas Friedman, recently wrote in JAMA , “Tobacco is, quite simply, in a league of its own in terms of the sheer numbers and varieties of ways it kills and maims people.” Read full post »

Reducing Poverty And Improving Health

Yesterday marked the 50th anniversary of Lyndon B Johnson’s 1964 State of the Union address where he made a proclamation to commit to end poverty in our rich nation. Nationally, there has been a huge and beautiful focus on the anniversary. Despite the political divisions and tense partisan discussions on how to proceed in poverty reduction, I heard many reports on the radio, read newspaper coverage, and saw chatter all day on social channels about where we stand. I was floored by the statistics. I’d not, unfortunately, ever before spent time thinking about Johnson’s proclamation and the line in the sand created by his words.

After his proclamation, the country went to work creating Medicare, Medicaid, Head Start (promoting school readiness through social, nutritional, developmental support for children from birth to age 5), food stamp programs, and Job Corps. Since 1965, Head Start alone has served more than 30 million children and set precedent for contemporary thinking on early education and consortiums today like Thrive by Five. Much of the media coverage yesterday focused on the profound progress we’ve made helping Americans quit or reduce cigarette smoking with the Surgeon General’s first Report on Smoking and Health. Still, nearly 1 in 5 Americans (18%) smoke in a country that has proven cigarettes to be the #1 leading cause of preventable death. Dr Thomas Frieden wrote in JAMA yesterday, “Tobacco is, quite simply, in a league of its own in terms of the sheer numbers and varieties of ways it kills and maims people.” Read full post »

My Adorable Activity Tracker. I’m Streaking!

First Day With My Shine

Self-tracking, life-logging, activity-tracking, “the quantified-self (QS) movement” as the smarty-pants say, or as some have asked, “What’s with the weird watch?” Well, I’m hooked. I don’t go anywhere these days without my device. My activity tracker had me at hello.

Over the summer I started wearing the Shine. I’d been waiting for it–it had a significantly delayed shipping date–which only heightened my desire. I’ve worn it every day (except one) since. The world really is different to me now. Before you start to criticize and marginalize my proclamations, know that I waited nearly 1/2 a year to write about this to ensure it wasn’t just a fad.

How My Activity Tracker Is Changing Me:

First things first: I realized how sedentary some of my days are. Especially when I’m writing or working intensely; knowing this has changed how I think about walking. Secondly, I’m really much happier knowing how much movement I have during a day rather than guessing about it. Even when I’ve hardly moved a few paces, I’m thankful for the insight. I mean, some days we pig out, some days we aren’t as hungry and eat salad, some days we run miles. Other days we work and write and sit far too long. My activity tracker helps me understand the patterns and think about new ways to live differently. The boys always want to know how much we’ve moved. This tracker has power around here. If there’s any New Year’s “resolution” that may be worth committing to–it may simply be to check in on how you’re moving. Find a tool to give you observable data. Behavior change perhaps will follow.

To be clear, it isn’t the device I’m attached to that is changing my life, it’s the new experiences I’ve having because of it. New insight from my Shine changes my mood, the way I map out my day, and has undoubtably made me more self-aware. I’m thankful for my consultant.

Reality is, many of us are tracking our lives and our movement without realizing it. Before you write we trackers off, read on.

Read full post »

Simplifying Health Care

StrikeWe all want simple solutions to living a healthy life.

It feels like I was born at just the right time for my work in health care. I completed my medical training just as social tools were percolating out to the masses. Motherhood and my practice of pediatrics auspiciously coincided with the bounty of information that technology has distributed, offered up, and shared unlike ever before.

I can search and learn about health wherever I am –  at the park or in the walls of my own clinic or home. For me, using my phone, Twitter, my blog, apps, Facebook, activity tracker, and patient online communities to provide health care, consume it, and engage in it is my new reality. It turns out, amidst all the clutter and stress of health care reform and our reduced time with our own doctors I can see clearly that intuitive ways of learning about science wed with thoughtful technology will let us care, cure, and prevent illness and injury like never before.

A survey published today finds that more that 3/4 of moms search online for symptoms. The majority of mothers in the US also look up information regarding their child’s development online, read about a medicine, or track their pregnancy with online tools. I’ve done, or do, all of those things. Don’t you?

I’ve just started a new job in the hospital overseeing a group in Digital Health. Our goal is to rapidly improve the way we serve children and their family’s unique needs in the hospital, clinical setting, and community. I want to help facilitate elegant communication between parents, patients, families, and their clinicians & surgeons when they are outside the hospital or clinic. Reason is: it seems to me that the luxury of our time is the one-to-many communication we have in our pockets. Over 60% of all American adults have a smartphone in their pocket and  crowd-sourcing happens at virtual water coolers (ie Facebook) every day. Over 40% of Americans log onto Facebook everyday to listen, lurk, snoop, learn, and vet ideas. Read full post »

Arriving Early: World Prematurity Day

Screen Shot 2013-11-13 at 10.03.17 PM

I think about the essay Welcome to Holland by Emily Perl Kingsley a lot. Her explanation of what it’s like to raise a child with a disability helps approximate (for me) the unexpected realities that ensue for families who encounter significant pediatric health challenges. Although her essay is not about prematurity and it’s not new, when I sat down to write about World Prematurity Day I couldn’t help but think back to her words and her metaphor. What’s marvelous, of course, is that her essay is built of love so all of us have a chance to understand it.

Sunday, World Prematurity Day, is a day to think cautiously, bravely, and empathetically about the opportunity to improve the lives of children born prematurely, all around the world. When a child arrives early there are obviously significant health challenges not only to survival but to a long life thereafter, sometimes with significant disability. Parents all over world suffer and learn to thrive with and after prematurity every single day. In fact,

Prematurity is the leading cause of death in newborns. Although some risk factors are known for preterm birth, we don’t know very much about the cause.

None of us will really ever know what it’s like to survive and thrive in someone else’s experience. So we share stories, quotes, photos, and moments as best we can to help others understand. As I’ve met and been invited to help care for parents, families and children who are born prematurely, one thing is certain — it’s a journey. It starts often with surprise and evolves individually. The essay by Kingsley is clearly about the journey, not about the diagnosis of prematurity at the time of birth.

Here’s what a colleague and friend, Kim, shared with me about her experience with her twin daughters who were born over three months early: Read full post »